Background Although 8-10% of pediatric residents pursue a career in Pediatric Hospital Medicine (PHM), many report an incomplete understanding of PHM careers and would benefit from a PHM elective. Methodology We followed Kern’s six-step curriculum development framework. A general needs assessment via literature review revealed a lack of published PHM elective curricula. A targeted needs assessment was conducted by surveying national PHM fellowship program directors, national PHM fellows, local junior PHM attendings, and local pediatric residents. Content analysis from these surveys was used to develop a PHM resident elective curriculum. The curriculum was implemented and evaluated through an experience log and written reflections. Results Needs assessment surveys were completed by fellowship directors (22/61, 36%), fellows (36/103, 35%), attendings (10/26, 38%), and residents (15/98, 15%). Common themes included the importance of academic experiences, mentorship, non-teaching and non-inpatient clinical experiences, community hospital experience, and the desire to address knowledge gaps. Significant variability in survey responses suggested the importance of an individualized curriculum. Goals, objectives, and aligned educational strategies were developed to provide a breadth of clinical experiences, mentorship, and PHM-focused academic activities, with an emphasis on individualization. Implementation of the curriculum began in July 2021 and four residents enrolled in 2021-2022. The curricular evaluation demonstrated the achievement of objectives and improved resident awareness of PHM opportunities, clinical skill development, ancillary shadowing, and academic opportunities. Conclusions A PHM resident elective was developed using Kern’s six-step approach with input from national fellows and fellowship program directors to address educational gaps and increase exposure to PHM careers. The next steps include the evaluation of the impact of the PHM elective on career choice and preparedness of residents.
BACKGROUND: Vaccine hesitancy may lead to delayed or incomplete vaccination, increased risk of vaccine-preventable disease and distrust between pediatricians and families. Studies have shown many pediatric providers are uncomfortable addressing parental concerns and educating hesitant parents on vaccine safety, necessity and misconceptions, yet few curricula to fill this need have been published. We developed and implemented a comprehensive longitudinal curriculum for pediatric residents on vaccine hesitancy and evaluated its efficacy via randomized controlled trial, hypothesizing that residents undergoing the curriculum would demonstrate improved knowledge, comfort and communication skills with vaccine hesitant families compared to a control group.METHODS: Using Kern's curriculum design framework, we designed and implemented didactic sessions for each pediatric vaccine and interactive role-playing sessions on communication skills. Half the pediatric residents were randomized to the intervention group (IG) and received the curriculum over 1 year; the control group (CG) received standard education only. Residents completed written pre and posttests and a standardized patient (SP) assessment at the end of the study period; group differences were evaluated using independent t-tests.RESULTS: 35 residents were randomized to IG and 35 to CG. Pre-test scores did not differ significantly between the 2 groups. The CG did not show a significant difference between pre and posttest scores for didactic knowledge or reported comfort level. The IG showed a significant increase in both knowledge and comfort level post curriculum. IG pretest knowledge score increased from 47% to 66%,p=0.00. IG pretest comfort level increased from 2.9/5 to 3.76/5,p=0.00. IG group SP score was significantly higher than the CG: 78% vs. 52%,p=0.00.CONCLUSION: Implementation of a comprehensive curriculum on vaccine hesitancy resulted in improvements in vaccine knowledge base, communication skills and comfort level with vaccine hesitancy discussions in pediatric residents. Studies should be done to assess the impact of such a curriculum on patients and vaccination rates.
Neurodegenerative diseases affect more than 7 million Americans. Our laboratory has developed models of the most prevalent human neurodegenerative disorder, Alzheimer's disease (AD), in Drosophila so that we can use the genetic tools available in these simple model organisms to study proteins and pathways regulating disease pathogenesis. Recently it has been suggested that TAR DNA‐binding protein 43 (TDP‐43), a DNA/RNA binding protein, may play a role in neurodegenerative disease, due to its presence in large aggregates in neurons of patients with frontal temporal lobar dementia and amyotrophic lateral sclerosis, as well as many cases of AD. Despite aggregation and deposition of TDP‐43 in AD brains, the functional role of TDP‐43 in the pathogenesis of AD is currently unclear. We investigated the role of TDP‐43 in AD‐related neurodegeneration by reducing levels of the Drosophila homolog of TDP‐43, TBPH, in control and AD model flies. Our data demonstrates that reducing the level of TBPH in transgenic flies expressing human Abeta1‐42 in retinal cells increases the severity of Abeta toxicity. Importantly, the equivalent reduction of TBPH in the absence of transgenic Abeta has no clear effect on the retina. The worsening of retinal pathology with decreased levels of TBPH suggests TDP‐43 as a candidate disease modifier in AD.
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